Patients' choice of healthcare providers and predictors of modern healthcare utilisation in Bangladesh: Household Income and Expenditure Survey (HIES) 2016-2017 (BBS).

OBJECTIVES: The number of modern healthcare providers in Bangladesh has increased and they are well equipped with modern medical instruments and infrastructures. Despite this development, patients seeking treatment from alternative healthcare providers are ongoing. Hence, this study aims to determine the underlying predictors of patients' choosing modern healthcare providers and health facilities for getting treatments. SETTING: Data from the nationally representative Household Income and Expenditure Survey 2016-2017 conducted by the Bangladesh Bureau of Statistics were used. PARTICIPANTS: 34 512 respondents sought treatment for their illnesses from different types of available healthcare providers. PRIMARY AND SECONDARY OUTCOME MEASURE: Patients' choice of healthcare providers (primary) and predictors of patients' choice of modern healthcare providers (secondary). RESULTS: The study found that 40% of the patients visit modern healthcare providers primarily on having symptoms of illness, and the remainder goes to alternative healthcare providers. Patients living in urban areas (adjusted OR (AOR)=1.11, 95% CI 1.05 to 1.17, p<0.01), and if the travel time was between 1 and 2 hours (AOR=1.11, 95% CI 1.00 to 1.22, p<0.05) compared with travel time less than 1 hour, were positively associated to utilisation of modern healthcare facilities for their first consultation. The statistical models show that the predisposing and need factors do not significantly impact patients' choice of modern healthcare providers. CONCLUSIONS: The distribution of modern healthcare providers should be even across the country to eliminate the rural-urban divide in modern healthcare utilisation. Enhancing the digital provision of modern healthcare services could reduce travel time, omit transportation costs and save waiting time for treatment by the modern healthcare providers. Policymakers can think of introducing a national health insurance programme in Bangladesh as a potential policy instrument.